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Purpose

To characterize treatment patterns and real-world clinical outcomes of patients with metastatic non–small cell lung cancer (mNSCLC) who developed progression on an anti–PD-1/anti–PD-L1, herein referred to as anti–PD-(L)1, and platinum-doublet chemotherapy.

Methods

Eligible oncologists/pulmonologists in the U.S., Europe (France, Germany, and the U.K.), and Japan completed electronic case report forms for patients with mNSCLC (no evidence of EGFR/ALK/ROS1 alterations). Eligible patients had disease progression on/after an anti–PD-(L)1 and platinum-doublet chemotherapy (received concurrently or sequentially), initiated a subsequent line of therapy (LOT) from 2017 through 2021, and had an Eastern Cooperative Oncology Group (ECOG) performance status 0-2 at this subsequent LOT initiation (index date). Overall survival (OS), time to treatment discontinuation (TTD), and real-world progression-free survival (rwPFS) after index were assessed using Kaplan-Meier analysis.

Results

Overall, 160 physicians (academic, 54.4%; community, 45.6%) provided de-identified data from 487 patient charts (U.S., 141; Europe, 218; Japan, 128; at mNSCLC diagnosis: median age 66 years, 64.7% male, 81.3% nonsquamous, 86.2% de novo mNSCLC; at line of interest initiation: 86.0% ECOG 0-1, 39.6% liver metastases, 18.9% brain metastases, 79.1% smoking history). The most common treatment regimens upon progression after anti–PD-(L)1/platinum-doublet chemotherapy were nonplatinum chemotherapy (50.5%), nonplatinum chemotherapy plus vascular endothelial growth factor receptor inhibitor (12.9%), and platinum-doublet chemotherapy (6.6%). Median OS was 8.8 months (squamous, 7.8 months; nonsquamous, 9.5 months). Median TTD was 4.3 months (squamous, 4.1 months; nonsquamous, 4.3 months). Median rwPFS was 5.1 months (squamous, 4.6 months; nonsquamous, 5.4 months).

Conclusion

In this multiregional, real-world analysis of pooled patient chart data, patients with mNSCLC who had disease progression after anti–PD-(L)1/platinum-doublet chemotherapy had poor clinical outcomes with various treatment regimens, demonstrating an unmet clinical need for effective options after failure on anti–PD-(L)1 and platinum-doublet chemotherapy treatments.

Read a Q&A related to the study here.